A 65 year old Afro Carribean female with sickle cell disease has a CXR during a sickle crisis. This shows smooth margined masses obliterating the paravertebral stripe on the right and descending thoracic aorta on the left.
What is the most likely diagnosis?
Castlemans disease | |
Extramedullary haematopoeisis | |
Lymphadenopathy | |
Neurogenic tumour | |
Lymphoma |
Extramedullary haematopoesis is a response to inadequate haemoglobin production and is seen in patients with haemolytic anaemias and myelofibrosis. Appearances on CT are of heterogenous soft tissue masses in the paravertebral regions with inhomogeneous contrast enhancement. The imaging appearances together with the clinical context are highly suggestive of extramedullary haematopoesis in this case. The other options are less likely in this case and have different imaging appearances, outlined in the short articles below.